Effect of aspiration on the lungs in children: a comparison using chest computed tomography findings

Abstract

Background Detecting and addressing aspiration early in children with dysphagia, such as those with cerebral palsy, is important for preventing aspiration pneumonia. The current gold standards for assessing aspiration are swallowing function tests, such as fiberoptic endoscopic evaluation of swallowing (FEES) and videofluorographic swallowing study; however, the relationship between aspiration of secretion vs aspiration of foodstuff and pulmonary injury is unclear. To clarify this relationship, we examined the correlations between pneumonia findings from chest computed tomography (CT) and the presence or absence of aspiration detected by FEES. Methods Eighty-five children (11 years 2 months ±7 years 2 months) underwent FEES and chest CT. Based on the FEES findings, the participants were divided into groups: with and without food aspiration, and with and without saliva aspiration. Correlations between chest CT findings of pneumonia and the presence or absence of each type of aspiration were then examined. Results No significant correlations were observed between food aspiration and chest CT findings of pneumonia, whereas saliva aspiration and chest CT findings of pneumonia were significantly correlated. In addition, saliva aspiration was significantly associated with bronchial wall thickening ( p < 0.01) and atelectasis ( p < 0.05). Conclusions Our findings in children suggest that: (1) the presence or absence of food aspiration detected by FEES evaluation has little correlation with pneumonia, and (2) the presence or absence of saliva aspiration may be an indicator of aspiration pneumonia risk.

Diagnosis and management of aspiration using fiberoptic endoscopic evaluation of swallowing in a Pediatric Pulmonology Unit

“…Moreover, it can cause pneumonia 19 . Salivary aspiration observed during FEES has also been associated with other radiological alterations, such as bronchial thickening and atelectasis 20 . Salivary aspiration in children with neurological disorders is generally caused by severe incoordination of swallowing and reduced sensitivity of the laryngopharynx, rather than due to excessive production of saliva.…”

Fatores De Risco Para Pneumonia Aspirativa Em Crianças Com Paralisia Cerebral: Revisão Integrativa

“…Esta rev isão da literatura revelou que os pr inc ipais f atores de r isco para a pneumonia aspirat iva em cr ianças por tadoras de paralisia Um ensaio clínico invest igou a cor rel ação de pneumonias diagnost icadas em tomograf ia de tórax com a presença ou ausênc ia de aspiração, em cr ianças (74,1% com PC), e ev idenc iou que a aspiração de saliva está rel ac ionada às pneumonias aspirat ivas 10 .…”

“…Por tratar-se de rev isão integrat iva, a pesquisa não foi submet ida ao Comitê de Ét ica em Pesquisa (CEP), porém foram mant idas as ideias dos autores das publicações ut ilizadas no desenvolv imento deste estudo. O f ator de r isco mais prevalente nesta rev isão foi a aspiração, descr ita pelos autores como aspiração de saliva 10,11 , aspiração silenc iosa [12][13][14] , aspiração crônica 15,16 , aspiração salivar crônica 17 , aspiração orof ar íngea 18 e aspiração direta 19 . Dez estudos concluíram algum t ipo de aspiração nas cr ianças pesquisadas.…”

Diagnosis and management of aspiration using fiberoptic endoscopic evaluation of swallowing in a pediatric pulmonology unit

“…Moreover, it can cause pneumonia 14 . Salivary aspiration observed during FEES has also been associated with other radiological alterations, such as bronchial thickening and atelectasis 15 . Salivary aspiration in children with neurological disorders is generally caused by a severe incoordination of swallowing and reduced sensitivity of the laryngopharynx, rather than due to excessive production of saliva.…”